Endocrine Abstracts

Case history: A 30-year old female presented with a 10-month history of enlarging neck mass, fatigue and weight gain. Assessment by her GP found her to have a large smooth goitre and biochemical hypothyroidism. The patient had a history of intestinal failure secondary to mitochondrial disorder. As a result of intestinal failure she was entirely dependent on parenteral nutrition and was intolerant of any oral intake, with venting of her stomach to reduce pain. She was referred ...

Introduction: Copeptin is the C-terminal fragment of proAVP and secreted in equimolar amounts with AVP. While AVP is unstable in vitro and has proved difficult to measure in clinical practice, copeptin is relatively stable and can be measured using an automated immunoassay. Therefore copeptin measurement offers potential as a more practical alternative to the direct measurement of AVP in the investigation of polyuria/polydipsia.Methods: AVP, cop...

Since the introduction of the reduction in hours for junior doctors in 1991, nurse led clinics (NLC) have increasingly become embedded into specialist practice. Whilst some NLC such as Diabetes and Respiratory have been established for many years, in the area of Endocrinology they are a newer evolving concept.Currently there is limited research in this area. An online survey was distributed to 98 nurse members of the Society for Endocrinology. The questi...

Background: Pre-pituitary surgery, patients attend a ‘Pre-Pituitary Surgery Clinic’ (PPSC), to discuss management options and risks. Clinicians in attendance are; pituitary surgeon (1) registrar (1) endocrine team consultants (1–3), registrars (1–2) nurses (1) senior house officer (1) visiting doctors/medical students (4–6). Patients are informed a number of clinicians attend the clinic due to the multidisciplinary nature (MDT) and unit teaching respon...

A 34-year-old male with two decades of gender identity issues considered gender reassignment and attended pre-orchidectomy sperm-banking when he was found to be azoospermic. He described a history of difficulty learning to play the piano and of deep-vein thrombosis at 19 years. He was 187 cm tall with a span of 189.7 cm, and exhibited L-sided undescended testis, R testis 1.8×2.5×3.7 cm, bilateral prominent gynaecomastia, a female body habitus, micropenis, bimanual sy...

The development of insulin resistance and type 2 diabetes mellitus (T2DM) in obesity involves (a) adipose inflammation, and (b) restricted adipose expansion with ectopic lipid deposition. Metalloproteinases (MPs) and tissue inhibitors of metalloproteinases (TIMPs) constitute a key regulatory system in inflammation and tissue remodelling. Evidence of MP and TIMP involvement in adipose tissue inflammation and modulation of adipose expansion is currently restricted to work in adi...

A 54-year-old lady with a 27-year history of schizoaffective disorder presented with shaking episodes, polyuria and polydipsia. She was found to have a serum sodium of 157 mmol/l. Of note, she had been on lithium for several years but this had been stopped three months previously as her serum sodium was raised at 156 mmol/l.On admission her lithium level was undetectable, confirming no recent use. Serum osmolality was 343 mOsm/kg and urine osmolality 82 ...

Introduction: CT renal tract is commonly requested by the urologists for suspected renal colic as it is recognized as the most accurate technique for the detection of ureteric stones. However, follow-up of adrenal incidentalomas identified on such scans could pose a challenge for the non-endocrinologist. We investigated the prevalence and follow-up of incidentally discovered adrenal masses after CT renal colic.Methods: We looked through the reports of al...

Ectopic (or ‘illegitimate’) transcripts, which have been widely used to study disease-causing mutations when samples from the appropriate tissue cannot be obtained, are generally faithful representations of the normal tissue-specific counterparts. Here, we report the occurrence of ectopic transcripts of the hepatocyte nuclear factor-1 beta (HNF-1β) gene, mutations of which may result in maturity onset diabetes of the young type 5 (MODY5), the renal cysts ...

A 63-year-old type 2 diabetic gentleman with paranoid schizophrenia presented in October 2008 with systemic sepsis arising from multiple neuropathic foot ulcers. Foot MRI confirmed extensive osteomyelitic change. This admission followed two previous similar episodes which culminated in surgical debridement of the ulcers and amputation of the second and third toe of his left foot. Post-operatively, as his condition improved he was unable to comply with IV antibiotics, VAC dress...